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用Flu和Ara-c的改良方案预处理后自体造血干细胞移植治疗急性白血病临床观察
引用本文:蔡小矜,马巧玲,王玫,杨栋林,阎嶂松,姜尔烈,黄勇,魏嘉璘,何祎,张桂新,杨帆,冯四洲,韩明哲. 用Flu和Ara-c的改良方案预处理后自体造血干细胞移植治疗急性白血病临床观察[J]. 生物医学工程与临床, 2010, 14(2): 146-150. DOI: 10.3969/j.issn.1009-7090.2010.02.015
作者姓名:蔡小矜  马巧玲  王玫  杨栋林  阎嶂松  姜尔烈  黄勇  魏嘉璘  何祎  张桂新  杨帆  冯四洲  韩明哲
作者单位:中国医学科学院,北京协和医学院,血液病医院和血液学研究所造血干细胞移植中心,天津,300020
基金项目:教育部博士点新教师基金 
摘    要:
目的评价采用氟达拉滨(Flu)和阿糖胞苷(Ara-c)改良的预处理方案进行自体造血干细胞移植(AHSCT)治疗急性白血病的安全性和疗效。方法27例急性白血病患者,其中男性18例,女性9例;年龄12~51岁,中位年龄20岁。急性淋巴细胞白血病(ALL)21例;急性髓细胞性白血病(AML)5例。均采用包含Flu和Ara-c的预处理方案进行AHSCT,方案包括全身照射(TBI)7~8Gy或白消胺(Bu)3.2mg/(kg·d)×3d联合环磷酰胺(Cy)50mg/(kg·d)×2d、Flu30mg/(m^2·d)×3d、Ara-c2g/(m^2·d)×3d。结果除1例患者早期死亡外,所有患者均成功重建造血系统,中性粒细胞恢复至大于0.5×109/L、血小板恢复至20×109/L的中位时间分别为11(9~19)d和16(10~55)d。预处理过程中无严重不良事件发生,移植相关死亡率(TRM)7.4%(2例)。4年总体复发率(RR)、TRM和无病生存率(DFS)分别为38.8%±10.3%、9.3%±5.7%、60.8%±9.8%。结论在AHSCT治疗急性白血病中,以Flu、Ara-c改良的TBI/Cy或Bu/Cy预处理方案髓外毒性小,无病生存率较高,可作为急性白血病预处理的一种有效选择。

关 键 词:自体造血干细胞移植  预处理方案  氟达拉滨  阿糖胞苷

Clinical study on autologous hematopoietic stem cells transplantation in acute leukemia after pretreated by modified regimen with fludarabine and cytarabine
CAI Xiao-jin,MA Qiao-ling,WANG Mei,YANG Dong-lin,YAN Zhang-song,JIANG Er-lie,HUANG Yong,WEI Jia-lin,HE Yi,ZHANG Gui-xin,YANG Fan,FENG Si-zhou,HAN Ming-zhe. Clinical study on autologous hematopoietic stem cells transplantation in acute leukemia after pretreated by modified regimen with fludarabine and cytarabine[J]. Biomedical Engineering and Clinical Medicine, 2010, 14(2): 146-150. DOI: 10.3969/j.issn.1009-7090.2010.02.015
Authors:CAI Xiao-jin  MA Qiao-ling  WANG Mei  YANG Dong-lin  YAN Zhang-song  JIANG Er-lie  HUANG Yong  WEI Jia-lin  HE Yi  ZHANG Gui-xin  YANG Fan  FENG Si-zhou  HAN Ming-zhe
Affiliation:CAI Xiao-jin,MA Qiao-ling,WANG Mei,YANG Dong-lin,YAN Zhang-song,JIANG Er-lie,HUANG Yong,WEI Jia-lin,HE Yi,ZHANG Gui-xin,YANG Fan,FENG Si-zhou,HAN Ming-zhe(Center of Transplantation,Institute of Hematology,Chinese Academy of Medical Sciences & Peking Union Medical College,Tianjin 300020,China)
Abstract:
Objective To analyze the efficacy of pretreatment with combined fludarabine(Flu) and cytosine arabinoside(Ara-c) regimen in patient with acute leukemia(AL) receiving autologous hematopoietic stem cells transplantation(AHSCT).Methods From January 2005 to December 2008,a total of 27 AL patients were enrolled,male 18,female 9;aged 12-51 years,median age 20 years,including 21 cases acute lymphocytic leukemia(ALL) and 5 cases acute myelocytic leukemia(AML) received AHSCT after pretreatment by Flu and Ara-c regim...
Keywords:autologous hematopoietic stem cells transplantation  conditioning regimen  fludarabine  cytosine arabinoside  
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